In the 1970s, anthropologist Marcha Flint studied 483 middle age Indian women of the Rajput caste in Rajasthan and Himachal Pradesh. She found that very few women complained of any perimenopause symptoms at all, other than menstrual changes.
Marcha Flint wondered why this should be the case: if these women's periods had stopped, surely they were undergoing the same hormonal changes as women in Europe and North America?
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Valuable older women
Marcha Flint proposed an interesting theory that might explain her findings. Perhaps the reason that Indian middle age women were not experiencing negative symptoms, was because their social status improved after menopause.
In these societies, once women were no longer menstruating and fertile, they were seen as no longer being "contaminative".
"In Rajasthan, Rajput women who, until their menopause, had to live in purdah (veiled and secluded) could now come downstairs from their women’s quarters to where the men talked and drank home brew; they could partake of these activities – something never allowed before this time. In Himachal Pradesh, the Rajput women could publicly visit and joke with men after attaining menopause."
Flint M. 1975 (1)
In her article Marcha Flint discusses the following possibility:
If middle age women gain status with menopause, rather than lose status, then could it be that they do not suffer the so-called "menopausal syndrome"?
Flint gives examples of other cultures where middle aged women are treated in a much more positive way:
As Flint argues, this is a huge contrast to Western cultures, where our dominant obsession sees youth and glamour as some kind of ideal that we are supposed to strive for at all costs.
Struggle to stay young
Many middle age women feel so pressurised to "remain young" that they undergo plastic surgery and spend fortunes on cosmetics and other products that promise "eternal youth".
Because of the media hype that promotes the perfect female as being a wrinkle-free and skinny girl of 20 years or younger, the rest of us and especially the over 40s, are left feeling worthless and invisible.
Of course, many, many women overcome this ridiculous programming and blossom at midlife. We travel, we educate ourselves and others, we contribute, we lead and we create.
But as Flint comments:
"for those who cannot, fear begins at forty and it’s downhill after that, with death waiting at the end. Is it any wonder that two million American women suffer severe menopausal symptoms? In our culture, there is no reward for attaining menopause. In fact, for many women it’s a time of punishment." (1)
Could it be, that by demonising the menopause as the harbinger of death and decay, our society creates a special kind of stress for women, so that through sheer dread we develop the so-called menopause syndrome?
Could menopause symptoms develop as a result of a kind of reverse placebo effect? A placebo treatment (sugar pill) can make a sick person enjoy a real improvement in symptoms of as much as 35%. Although no-one really understands why, placebo effects work because the patient (and their doctor) really expect the treatment to work, even though the truth is that there is no active ingredient.
Could it be that by creating unconscious expectations that women will suffer at menopause – our society is actually creating or exacerbating menopause symptoms?
How far this theory can go in explaining the differences observed in perimenopause symptoms between different cultures is of course highly debatable.
But it’s curious and highly intriguing too!
Life course effects
Since Marcha Flint's work in India, other anthropologists have suggested that although middle age women's status may contribute to cultural variation in menopause experience, it is by no means the whole story.
These researchers argue that other factors such as diet, fertility patterns and genetics also play a role (2). Perhaps too, menopause is influenced by what Margaret Lock has called "local biologies"- a complex interplay between culture and biology(3).
Whatever your view of this debate, it does seem reasonable, that if the whole menopausal process is a social and cultural taboo – and if women feel embarrassed by their hot flushes and sweats, the anxiety that accompanies the embarrassment can only make the hot sensation worse.
After all, flushing and sweating are well-recognised signs of stress and anxiety in everybody.
The cup half full
A much more positive image of older and middle age women in Western culture can only have a good influence on our menopause journeys. If middle age women everywhere make a stand, we can become much more valued and respected.
We need to challenge the misogynous stereotype that views the "perfect feminine" as a nubile girl, scarcely out of adolescence.
And we need to stop feeling anxious and embarrassed by the perfectly normal physical sensations that come with menopause.
Valuing Middle Aged Women
It's time to build a positive and valued image of middle age and older women in Western culture. And with this improved image we can bring the menopause out of the closet and into the light of day. And then maybe we can stop being apologetic about our bodies at last!
Midlife is an exciting time for most middle age women. It's the time when we're mature and confident enough to make real progress towards achieving our personal aspirations and goals and yet we're physically still strong, sexy and energetic.
It's the prime of our life and menstruation stopping is just a marker stone in the much bigger river of all that's going on in our lives.
We’ve got much more important things to do than to let these hormonal changes get in the way of our transformative journey.
1. Flint M. The menopause: reward or punishment? Psychosomatics. 1975;16(4):161-163.
2. Beyene Y. Cultural signficance and physiological manifestations of menopause; a biocultural analysis. Culture, Medicine & Psychiatry 1986;10:47-71.
3. Lock M. Encounters with Aging: Mythologies of Menopause in Japan and North America. Berkeley: University of California Press; 1993.
Published June 2010. Re-written September 2012.